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Case Report

Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report

  • Authors:
    • Runfeng Zhang
    • Lili Cheng
    • Jinghua Liu
    • Lu Zhang
    • Junling Zhuang
  • View Affiliations / Copyright

    Affiliations: Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China
  • Article Number: 295
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    Published online on: September 8, 2026
       https://doi.org/10.3892/etm.2026.13290
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Abstract

Multiple myeloma (MM) is a plasma cell malignancy, and extramedullary plasmacytoma (EMP) is associated with an aggressive biology and poor outcomes. B‑cell maturation antigen (BCMA)‑directed chimeric antigen receptor T‑cell (CAR‑T) therapy has shown substantial activity in relapsed/refractory MM (RRMM); however, evidence in patients with EMP, particularly after prior BCMA CAR‑T exposure, remains limited. The present study describes the case of a 38‑year‑old man with RRMM and extensive cranial EMP who progressed after multiple prior therapies, including proteasome inhibitor‑ and immunomodulatory drug‑based regimens, anti‑CD38 therapy, carfilzomib‑based therapy and a previous non‑humanized BCMA CAR‑T product. Due to rapidly progressive disease, the patient received bridging cytoreduction followed by fully humanized BCMA CAR‑T therapy (equecabtagene autoleucel). After infusion, serum and urine M‑protein levels rapidly declined and the craniofacial mass regressed clinically and radiographically. The patient achieved stringent complete response with durable control of extramedullary disease during follow‑up. The present case suggests that fully humanized BCMA CAR‑T therapy may remain effective in selected patients with RRMM and EMP, even after prior non‑humanized BCMA CAR‑T failure. These findings support further investigation into retreatment strategies and post‑CAR‑T maintenance approaches.
View Figures

Figure 1

Serial craniofacial photographs taken
before and after fully humanized B-cell maturation antigen chimeric
antigen receptor T-cell infusion. (A) Baseline images before
equecabtagene autoleucel infusion (B) Photographs obtained 13 days
after infusion showing visible regression of the craniofacial
extramedullary mass.

Figure 2

Serial MRI monitoring of the right
parietal extramedullary lesion after fully humanized B-cell
maturation antigen chimeric antigen receptor T-cell infusion.
Closely matched sagittal cutting planes are shown across time
points. (A) Baseline, (B) day 13 after infusion and (C) 9 months
after infusion, demonstrating progressive reduction of the
extraosseous soft-tissue component.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Zhang R, Cheng L, Liu J, Zhang L and Zhuang J: Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report. Exp Ther Med 32: 295, 2026.
APA
Zhang, R., Cheng, L., Liu, J., Zhang, L., & Zhuang, J. (2026). Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report. Experimental and Therapeutic Medicine, 32, 295. https://doi.org/10.3892/etm.2026.13290
MLA
Zhang, R., Cheng, L., Liu, J., Zhang, L., Zhuang, J."Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report". Experimental and Therapeutic Medicine 32.5 (2026): 295.
Chicago
Zhang, R., Cheng, L., Liu, J., Zhang, L., Zhuang, J."Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report". Experimental and Therapeutic Medicine 32, no. 5 (2026): 295. https://doi.org/10.3892/etm.2026.13290
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang R, Cheng L, Liu J, Zhang L and Zhuang J: Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report. Exp Ther Med 32: 295, 2026.
APA
Zhang, R., Cheng, L., Liu, J., Zhang, L., & Zhuang, J. (2026). Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report. Experimental and Therapeutic Medicine, 32, 295. https://doi.org/10.3892/etm.2026.13290
MLA
Zhang, R., Cheng, L., Liu, J., Zhang, L., Zhuang, J."Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report". Experimental and Therapeutic Medicine 32.5 (2026): 295.
Chicago
Zhang, R., Cheng, L., Liu, J., Zhang, L., Zhuang, J."Relapsed/refractory multiple myeloma with extramedullary plasmacytomas successfully rechallenged with humanized B‑cell maturation antigen‑directed chimeric antigen receptor T‑cell immunotherapy in an advanced disease stage: A case report". Experimental and Therapeutic Medicine 32, no. 5 (2026): 295. https://doi.org/10.3892/etm.2026.13290
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